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Biomedical subjects

B Brun

Publications and source records attributed to B Brun.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Erdheim-Chester disease. The multiviceral form presenting as exophthalmos].

Erdheim-Chester disease is a rare visceral xantho-granulomatosis, the 17th case of which is reported here. The initial symptom, bilateral exophthalmos, was uncommon. The picture was completed by a retroperitoneal xanthogranuloma and by bilateral and symmetrical osteosclerosis of the long bones. The lack of X-bodies at electron microscopy differentiated the disease from Hand-Schüller-Christian disease. The patient's condition improved with chemotherapy (vinblastine and doxorubicin) combined with corticosteroid therapy. After a 5-month remission period, he died of an intercurrent infection. No autopsy was performed.

Diagnosis, Differential↗
PubMed1986

[Pre and postoperative chemotherapy of osteosarcoma with an adriamycin-cisplatin combination. Risks of a neoadjuvant chemotherapy which is not sufficiently effective].

The authors evaluated a new protocol of neoadjuvant chemotherapy for osteosarcoma, easier to manage and different from T10. The good results obtained with the postoperative ADR-CDDP association led us to undertake a pilot study between 1982 and 1984, using ADR-CDDP as preoperative chemotherapy. The records of sixteen patients were available for follow-up. The average age of the patients was 19.9 years. Patients received two or three preoperative courses, and a total of six identical courses. Tolerance was good. Pain usually disappeared but this was often misleading because associated with radiological and/or clinical tumor progression, low histological necrosis or poor outcome. The continuous disease-free survival actuarial rate was less than 57 and 40% at 18 months and two years respectively. The actuarial survival rate was 87% at one year and 65% at two years respectively. Disappointing results of this preoperative protocol, compared to results with the SO4 78 or T10 protocols for example, led to publish these data early in order to underline their potential dangers. As a result, we stopped our study. The charter of pilot studies justifies this publication. As well, these data point out the necessity of very close follow-up of neoadjuvant chemotherapy by sophisticated medical imaging. Neoadjuvant chemotherapy, if ineffective, must be stopped early, and should lead to surgery, followed by adequate postoperative chemotherapy.

Adolescent↗
PubMed1985

Acute promyelocytic leukemia in 57 previously untreated patients.

Fifty-seven patients in initial phase of acute promyelocytic leukemia (APL) were treated in the same department with heparin infusion, platelet transfusions, and two related induction regimens both including cytosine arabinoside and daunorubicin. Clinical and biological findings at presentation were studied. The complete remission (CR) rate was 53%. Twenty-seven patients (47%) died during the initial course of the disease, either before day 5 (early death [ED], n = 7) or after day 5 (death in aplasia [DA], n = 20). Most ED was due to intracerebral hemorrhage (6/7), especially when large hemorrhages had been seen on fundus oculi examination. Most DA was due to multivisceral failure (9/20). No correlation was found between initial disseminated intravascular coagulation (DIC) and death. However, the worsening of coagulation parameters during induction therapy, with or without initial DIC, significantly increased the occurrence of renal and respiratory failure which were particularly frequent during the first month. The median duration of survival was short (3.5 months) and the median duration of CR (11 months) was similar to that of other acute myeloid leukemias treated with the same regimens. The possible causes of the high mortality observed during the initial courses of APL and the possible benefit of a more graduate induction chemotherapy are discussed.

Acute Kidney Injury↗
PubMed1984

Transabdominal dynamic ultrasonography in detection of bladder tumors.

The accuracy of dynamic transabdominal ultrasonography in the detection of bladder tumors is examined. Of 49 bladder tumors 34 between 2 mm. and several centimeters in size could be demonstrated ultrasonographically. Ultrasound failed to visualize tumors less than 5 mm. in size in 14 patients. Dynamic transabdominal ultrasonography cannot replace cystoscopy in the diagnosis or followup of patients with bladder tumors but it may be used instead of cystoscopy in some selected cases.

Adult↗
PubMed1984

[Initial polychemotherapy in the treatment of cancers of the head and neck. The efficacy and tolerance of 2 nonrandomized combinations in 48 patients].

Before loco regional treatment for head and neck cancer forty eight patients received one or the other of the following combined chemotherapy regimens: Regimen A (28 patients): high dosage methotrexate, bleomycin, cis-platin; regimen B (20 patients): common dosage methotrexate, bleomycin, hydroxyurea, vincristin. The effectiveness of regimen A seemed better than that of regimen B (46% responses versus 20%). This assessment must be accepted with caution, since, although the organization of treatment was strictly similar in the two groups, the study was not randomized, and there were noticeable differences between the two groups. Regimen B was associated with no toxicity. Regimen A was responsible for two fatalities. These two cases were linked to high dosage methotrexate. However, a combined chemotherapy regimen of type A with the high dosage methotrexate replaced by intermediate dosage methotrexate, seems feasible to us. Loco regional treatment was not impaired by initial chemotherapy with either regimen.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Early response to chemotherapy as a prognostic factor in Hodgkin's disease.

In 164 patients with Hodgkin's disease staged between 1973 and 1979 the response to the 3 initial cycles of multiagent chemotherapy was evaluated as a prognosticator of survival. Treatment of localized disease (Stages I, II, III1) consisted of 3 cycles of chemotherapy followed by subtotal nodal irradiation, including the splenic area in non splenectomized patients. Treatment of extended disease (Stage III2 and IV) consisted of 6 cycles followed by low-dosage radiotherapy of initial bulky disease. Five-year actuarial survival was 88% in Stage I, 80% in II, 100% in III1, 45% in III2 and IV. Chemotherapy-induced complete remission after 3 cycles (CH leads to CR) was associated with a favorable prognosis. Five-year survival of Stage III2 and IV patients was better in those who reached CH leads to CR than in those who did not (75% versus 25%; P less than 0.01). This relationship between CH leads to CR and five-year survival was confirmed in patients with localized disease, as shown in Stage II patients (respectively 97% versus 63%; P less than 0.05). Therefore the response to initial chemotherapy provides a new prognostic factor that may serve to delineate a "high-risk" group of patients. The latter deserve aggressive therapy while those in the favorable group would benefit from a less aggressive combined regimen that would minimize long-term complications.

Antineoplastic Agents↗
PubMed1983

[Multiple myeloma with high tumoral mass. Treatment combining melphalan, cyclophosphamide, vincristine, CCNU and prednisone. 35 cases].

The results of a combination chemotherapy trial (melphalan, CCNU, vincristine, cyclophosphamide) involving 28 patients with stage III (n = 21) or stage II (n = 7) multiple myeloma suggest a high response rate, with a mean 71% malignant cell destruction in 78.5% of the patients. A longer survival in responsive stage III patients as compared with patients treated with alkylating agents seems likely, but this can only be established by a randomized trial. Despite haematological side-effects, this combination therapy may be used in high risk patients, especially those resistant to a single alkylating agent and in whom the frequency, intensity and duration of responses appears to be the same as in previously untreated patients. In contrast, only one of the 7 patients treated for relapse after previous response to a single alkylating agent responded to the combination chemotherapy.

Adult↗
PubMed1983

[Treatment of malignant glioma. Apropos of 39 cases].

Thirty-nine patients with malignant gliomas (36 glioblastomas, 3 astrocytomas grade III; age median 52.5) were treated after surgery by combination chemotherapy followed by irradiation. The median survival on the actuarial curve is 7 months. An attempt is made to evaluate each therapeutic modality by analysis of clinical and CT parameters.

Adult↗
PubMed1983

Radiological changes of the hands in systemic sclerosis.

Radiological examination of the hands was performed in 41 patients with systemic sclerosis. Pathological changes were found in 39 patients. Eighteen patients had subcutaneous calcifications and 11 had atrophy of the finger pulps. Bone resorption of ungual tufts was found in 11 patients. Juxta-articular osteoporosis was seen in 9 patients and periarticular bone erosions in 8 patients indicating erosive arthropathy. Osteoarthritis and generalized osteoporosis were seen in 10 and 7 patients, respectively. Radiological examination of the hands is recommended during treatment.

Adult↗